Huda Mega Hasanul, Chipojola Roselyn, Lin Yen Miao, Lee Gabrielle T, Shyu Meei-Ling, Kuo Shu-Yu
38032 School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
6221 Applied Psychology, Faculty of Education, Western University, London, ON, Canada.
J Hum Lact. 2022 Feb;38(1):156-170. doi: 10.1177/08903344211029279. Epub 2021 Jul 6.
Breast engorgement and breast pain are the most common reasons for the early cessation of exclusive breastfeeding by mothers.
(1) To examine the influence of breastfeeding educational interventions on breast engorgement, breast pain, and exclusive breastfeeding; and (2) to identify effective components for implementing breastfeeding programs.
Randomized controlled trials of breastfeeding educational interventions were searched using five English and five Chinese databases. Eligible studies were independently evaluated for methodological quality, and data were extracted by two investigators. In total, 22 trials were identified, and 3,681 participants were included. A random-effects model was used to pool the results, and a subgroup analysis and meta-regression analysis were conducted.
Breastfeeding education had a significant influence on reducing breast engorgement at postpartum 3 days (odds ratio [OR]: 0.27, 95% CI [0.15, 0.48] .001), 4 days (OR: 0.16, 95% CI [0.11, 0.22], < .001), and 5-7 days (OR: 0.24, 95% CI [0.08, 0.74], = .013) and breast pain (standardized mean difference: -1.33, 95% CI [-2.26, -0.40]) at postpartum 4-14 days. Participants who received interventions had higher odds of exclusive breastfeeding. Breastfeeding educational interventions provided through lecture combined with skills practical effectively reduced breast engorgement (OR: 0.21; 95% CI [0.15, 0.28]; = .001) and improved exclusive breastfeeding at postpartum 1-6 weeks (OR: 2.16; 95% CI [1.65, 2.83]; = .001).
Breastfeeding educational interventions have been effective in reducing breast engorgement, breast pain, and improved exclusive breastfeeding. A combination of knowledge and skill-based education has been beneficial for sustaining exclusive breastfeeding by mothers.
乳房胀痛和乳房疼痛是母亲过早停止纯母乳喂养的最常见原因。
（1）探讨母乳喂养教育干预对乳房胀痛、乳房疼痛和纯母乳喂养的影响；（2）确定实施母乳喂养计划的有效组成部分。
使用五个英文数据库和五个中文数据库检索母乳喂养教育干预的随机对照试验。对符合条件的研究进行独立的方法学质量评估，由两名研究人员提取数据。共识别出22项试验，纳入3681名参与者。采用随机效应模型汇总结果，并进行亚组分析和元回归分析。
母乳喂养教育对产后3天（比值比[OR]：0.27，95%可信区间[CI][0.15,0.48]，P<.001）、4天（OR：0.16，95%CI[0.11,0.22]，P<.001）和5-7天（OR：0.24，95%CI[0.08,0.74]，P=.013）的乳房胀痛以及产后4-14天的乳房疼痛（标准化平均差：-1.33，95%CI[-2.26,-0.40]）有显著影响。接受干预的参与者进行纯母乳喂养的几率更高。通过讲座结合技能实践提供的母乳喂养教育干预有效地减轻了乳房胀痛（OR：0.21；95%CI[0.15,0.28]；P=.001），并改善了产后1-6周的纯母乳喂养情况（OR：2.16；95%CI[1.65,2.83]；P=.001）。
母乳喂养教育干预在减轻乳房胀痛、乳房疼痛和改善纯母乳喂养方面是有效的。基于知识和技能的教育相结合有利于母亲维持纯母乳喂养。
